Intake Survey

Thank you for your interest in working with RE-Center, Race & Equity in Education. We are excited to get to know more about you and the work that you envision. Please make space to fill in the following intake survey, and a member of the team will respond to you in 2 - 3 business days.

Please note that due to the COVID-19 pandemic, we will be hosting all of our workshops virtually until January 2021.

Thank you for letting us be a part of your community!

Question Title

* 1. Address

Name

Name of Organization

Role

Address 2

City/Town

State/Province

Email Address

Phone Number

Question Title

* 2. Type of Organization

Educational (schools/districts/educators)

Philanthropic

Nonprofit

Private Sector

Faith based

Other (please specify)

Question Title

* 3. If you are an educational organization, what kind of assistance/services are you seeking from RE-Center, Race & Equity in Education?

Racial Equity Programming and Facilitation

Technical assistance and capacity building (coaching, consulting, strategic planning)

Other (please specify)

Question Title

* 4. If you are a philanthropic, nonprofit, private sector, or faith-based organization, what kind of assistance/services are you seeking from RE-Center Consulting? Check off all that apply.

Racial equity assessment

Racial equity training

Racial equity leadership teams

Racial equity strategic planning

Racially equitable policies, practices, systems

Racial equity culture shift

Racial equity coaching

Racially equitable leadership development/succession planning

Racially equitable board/governance

Other (please specify)

Question Title

* 5. What demographic are you looking to work with?

Any more information about who would be participating in the workshop? What are the demographics of those people? Age? Gender? Race? Position title?

Question Title

* 6. What type of program are you looking for?

Single Facilitation/ Training

Facilitation/Training Series

Technical assistance

Something else/ I am not sure